<!DOCTYPE html>
<html lang="zh_CH">

<head>
    <meta charset="UTF-8">
    <meta http-equiv="X-UA-Compatible" content="IE=edge">
    <meta name="viewport" content="width=device-width, initial-scale=1.0">
    <title>加盟申请表页面</title>
    <style>
        * {
            font-family: 宋体;
        }
        
        span.point {
            color: red;
        }
        
        p.tips {
            color: blue;
            font-size: small;
        }
        
        label.last {
            color: red;
        }
        
        input.submit {
            width: 70px;
        }
    </style>
</head>

<body>
    <form action="">
        <div class="headphoto">
            <img src="../img/apply_1.gif" alt="在线申请首图片">
        </div>
        <table class="maintable">
            <tr>
                <td>
                    <img src="../img/apply_2.gif" alt="在线申请logo图片">
                </td>
                <td>
                    <h2>加盟申请表</h2>
                    <p class="tips">注：打*为必填项</p>
                </td>
            </tr>
            <tr>
                <td>
                    <h3>代理申请基本信息</h3>
                </td>
            </tr>
            <tr>
                <td>
                    <span>申请人姓名</span><span class="point"> *</span>
                </td>
                <td>
                    <input type="text">
                </td>
            </tr>
            <tr>
                <td>
                    <span>籍贯</span><span class="point"> *</span>
                </td>
                <td>
                    <select name="province">
                        <option value="0" selected>请选择...</option>
                    </select><label> 省 </label>
                    <select name="county">
                        <option value="0" selected>请选择...</option>
                    </select><label> 区 </label>
                </td>
            </tr>
            <tr>
                <td>
                    <span>性别</span><span class="point"> *</span>
                </td>
                <td>
                    <input id="rd1" type="radio" name="sex" value="1"><label for="rd1">男</label>
                    <input id="rd2" type="radio" name="sex" value="0"> <label for="rd2">女</label>
                </td>
            </tr>
            <tr>
                <td>
                    <span>身份证号</span><span class="point"> *</span>
                </td>
                <td>
                    <input type="text">
                </td>
            </tr>
            <tr>
                <td>
                    <span>联系地址</span><span class="point"> *</span>
                </td>
                <td>
                    <input type="text">
                </td>
            </tr>
            <tr>
                <td>
                    <span>电话</span><span class="point"> *</span>
                </td>
                <td>
                    <input type="text">
                </td>
            </tr>
            <tr>
                <td>
                    <span>电子邮箱</span><span class="point"> *</span>
                </td>
                <td>
                    <input type="text">
                </td>
            </tr>
            <tr>
                <td>
                    <span>加盟地区</span><span class="point"> *</span>
                </td>
                <td>
                    <input type="text">
                </td>
            </tr>
            <tr>
                <td>
                    <span>你是从哪里了解到我们的？</span>
                </td>
                <td>
                    <input id="cb1" type="checkbox"><label for="cb1">Baidu</label>
                    <input id="cb2" type="checkbox"><label for="cb2">Google</label>
                    <input id="cb3" type="checkbox"><label for="cb3">电视广告</label>
                    <input id="cb4" type="checkbox"><label for="cb4">报刊杂志</label>
                    <input id="cb5" type="checkbox"><label for="cb5">路牌广告</label>
                    <input id="cb6" type="checkbox"><label for="cb6">朋友介绍</label>
                </td>
            </tr>
            <tr>
                <td>
                    &nbsp;
                </td>
                <td>
                    <input id="cb7" type="checkbox"><label class="last" for="cb7">点击查看“Android”项目网上加盟免责声明</label><a href="#"><span>［点击查看］</span></a>
                </td>
            </tr>
            <tr>
                <td>
                    &nbsp;
                </td>
                <td>
                    <input class="submit" type="submit">
                </td>
            </tr>
        </table>
    </form>
</body>


</html>